PMID- 28416009
OWN - NLM
STAT- MEDLINE
DCOM- 20170531
LR  - 20240325
IS  - 1472-6963 (Electronic)
IS  - 1472-6963 (Linking)
VI  - 17
IP  - 1
DP  - 2017 Apr 17
TI  - Use of Lot quality assurance sampling surveys to evaluate community health worker 
      performance in rural Zambia: a case of Luangwa district.
PG  - 279
LID - 10.1186/s12913-017-2229-9 [doi]
LID - 279
AB  - BACKGROUND: The Better Health Outcomes through Mentoring and Assessment (BHOMA) 
      project is a cluster randomized controlled trial aimed at reducing 
      age-standardized mortality rates in three rural districts through involvement of 
      Community Health Workers (CHWs), Traditional Birth Attendants (TBAs), and 
      Neighborhood Health Committees (NHCs). CHWs conduct quarterly surveys on all 
      households using a questionnaire that captures key health events occurring within 
      their catchment population. In order to validate contact with households, we 
      utilize the Lot Quality Assurance Sampling (LQAS) methodology. In this study, we 
      report experiences of applying the LQAS approach to monitor performance of CHWs 
      in Luangwa District. METHODS: Between April 2011 and December 2013, seven health 
      facilities in Luangwa district were enrolled into the BHOMA project. The health 
      facility catchment areas were divided into 33 geographic zones. Quality assurance 
      was performed each quarter by randomly selecting zones representing about 90% of 
      enrolled catchment areas from which 19 households per zone where also randomly 
      identified. The surveys were conducted by CHW supervisors who had been trained on 
      using the LQAS questionnaire. Information collected included household identity 
      number (ID), whether the CHW visited the household, duration of the most recent 
      visit, and what health information was discussed during the CHW visit. The 
      threshold for success was set at 75% household outreach by CHWs in each zone. 
      RESULTS: There are 4,616 total households in the 33 zones. This yielded a target 
      of 32,212 household visits by community health workers during the 7 survey 
      rounds. Based on the set cutoff point for passing the surveys (at least 75% 
      households confirmed as visited), only one team of CHWs at Luangwa high school 
      failed to reach the target during round 1 of the surveys; all the teams otherwise 
      registered successful visits in all the surveys. CONCLUSIONS: We have employed 
      the LQAS methodology for assurance that quarterly surveys were successfully done. 
      This methodology proved helpful in identifying poorly performing CHWs and could 
      be useful for evaluating CHW performance in other areas. TRIAL REGISTRATION: 
      Identifier: NCT01942278 . Date of Registration: September 2013.
FAU - Mwanza, Moses
AU  - Mwanza M
AD  - Centre for Infectious Disease Research in Zambia, Plot No. 5032, Great North 
      Road, P.O. Box 34681, Lusaka, Zambia. moses.mwanza@cidrz.org.
FAU - Zulu, Japhet
AU  - Zulu J
AD  - Centre for Infectious Disease Research in Zambia, Plot No. 5032, Great North 
      Road, P.O. Box 34681, Lusaka, Zambia.
FAU - Topp, Stephanie M
AU  - Topp SM
AD  - Centre for Infectious Disease Research in Zambia, Plot No. 5032, Great North 
      Road, P.O. Box 34681, Lusaka, Zambia.
AD  - University of Alabama at Birmingham, Birmingham, AL, USA.
FAU - Musonda, Patrick
AU  - Musonda P
AD  - University of Zambia, School of Medicine, Lusaka, Zambia.
FAU - Mutale, Wilbroad
AU  - Mutale W
AD  - University of Zambia, School of Medicine, Lusaka, Zambia.
FAU - Chilengi, Roma
AU  - Chilengi R
AD  - Centre for Infectious Disease Research in Zambia, Plot No. 5032, Great North 
      Road, P.O. Box 34681, Lusaka, Zambia.
AD  - University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT01942278
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20170417
PL  - England
TA  - BMC Health Serv Res
JT  - BMC health services research
JID - 101088677
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Clinical Competence/*standards
MH  - Community Health Workers/*standards
MH  - Family Characteristics
MH  - Female
MH  - Health Facilities
MH  - Humans
MH  - Lot Quality Assurance Sampling/*statistics & numerical data
MH  - Male
MH  - Midwifery/standards
MH  - Pregnancy
MH  - Prenatal Care/standards
MH  - Residence Characteristics
MH  - Rural Health
MH  - Surveys and Questionnaires
MH  - Young Adult
MH  - Zambia/epidemiology
PMC - PMC5393033
OTO - NOTNLM
OT  - Community Health Worker performance
OT  - Lot quality assurance sampling
OT  - Quarterly surveys
OT  - Rural Zambia
EDAT- 2017/04/19 06:00
MHDA- 2017/06/01 06:00
PMCR- 2017/04/17
CRDT- 2017/04/19 06:00
PHST- 2015/08/15 00:00 [received]
PHST- 2017/04/05 00:00 [accepted]
PHST- 2017/04/19 06:00 [entrez]
PHST- 2017/04/19 06:00 [pubmed]
PHST- 2017/06/01 06:00 [medline]
PHST- 2017/04/17 00:00 [pmc-release]
AID - 10.1186/s12913-017-2229-9 [pii]
AID - 2229 [pii]
AID - 10.1186/s12913-017-2229-9 [doi]
PST - epublish
SO  - BMC Health Serv Res. 2017 Apr 17;17(1):279. doi: 10.1186/s12913-017-2229-9.